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Visit patterns at primary care centres and individual blood pressure level - a cross-sectional study
H Ödesjö1,2, S Adamsson Eryd3, S Franzén4
1a Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy , University of Gothenburg , Gothenburg , SE 405 30 , Sweden.
Insights
Improving hypertension care requires optimizing primary health care centre (PHCC) organization. Increased nurse visits at PHCCs are associated with better blood pressure control in patients with hypertension.
Area of Science:
- Cardiology
- Public Health
- Healthcare Management
Background:
- Hypertension is a leading cause of cardiovascular disease.
- Blood pressure (BP) control remains suboptimal in many patients.
- Understanding factors influencing BP control is crucial for effective management.
Purpose of the Study:
- To investigate the relationship between primary health care centre (PHCC) visit patterns and individual blood pressure (BP) control.
- To identify organizational factors within PHCCs that may impact hypertension management.
Main Methods:
- A cross-sectional, register-based study was conducted on 88,945 patients aged 40-79 with uncomplicated hypertension in a Swedish region.
- Data from 188 PHCCs were analyzed to assess BP control rates and visit patterns.
- Odds ratios (OR) were calculated to determine the association between PHCC characteristics and achieving a BP target of ≤140/90 mmHg.
Main Results:
- Overall, 63% of patients achieved a BP of ≤140/90 mmHg (48% had BP <140/90 mmHg).
- Higher numbers of nurse visits at the PHCC level were associated with improved BP control (adjusted OR 1.10).
- Patients attending PHCCs with the highest proportion of nurse visits showed a significantly higher likelihood of achieving BP targets (OR 1.19).
Conclusions:
- Approximately half of the studied hypertensive population does not meet recommended treatment goals.
- PHCC organization and team-based care are recognized influencers of BP control.
- Findings suggest that enhancing PHCC organization, particularly through increased nurse-led care, could significantly improve hypertension management and outcomes.
Objective:
Hypertension is a major cause of cardiovascular disease. Nevertheless, blood pressure (BP) is often inadequately treated. We studied visit patterns at primary health care centres (PHCCs) and their relation to individual BP control.
Design And Setting:
Cross-sectional register-based study on all patients with hypertension who visited 188 PHCCs in a Swedish region.
Patients:
A total of 88,945 patients with uncomplicated hypertension age 40-79.
Main Outcome Measures:
Odds ratio (OR) for the individual patient to achieve the BP target of ≤140/90 mmHg.
Results:
Overall, 63% of patients had BP ≤ 140/90 mmHg (48% BP < 140/90). The PHCC that the patient was enrolled at and, as part of that, more nurse visits at PHCC level was associated with BP control, adjusted OR 1,10 (95% CI 1.01 to 1.21). Patients visiting PHCCs with the highest proportion of visits with nurses had an even higher chance of achieving the BP target, OR 1.19 (95% CI 1.07 to 1.32).
Conclusions:
In a Swedish population of patients with hypertension, about half do not achieve recommended treatment goals. Organisation of PHCC and team care are known as factors influencing BP control. Our results suggests that a larger focus on PHCC organisation including nurse based care could improve hypertension care.
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